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Recreational Dive Inquiry Form

Personal Information

First Name

Last Name

Date of Birth

Gender

Contact Information

Phone Number

Email

Emergency Contact

First Name

Last Name

Phone Number

Diving Experience

Have you ever gone diving before?

Type of diving:

Scuba

Snorkeling

Free diving

Other:

Number of dives:

Certification level

Last dive date:

Are you currently certified by a diving organization (e.g., PADI, SSI, NAUI)?

Certification level:

Certification number:

Expiry date:

Do you have any experience with the following? (Check all that apply)

Open water diving

Night diving

Deep diving

Wreck diving

Cave diving

Drift diving

Underwater photography

Health and Medical Information

Do you have any medical conditions that may affect your ability to dive safely?

If yes, please specify:

Are you currently taking any medications?

If yes, please list:

Have you ever experienced any of the following? (Check all that apply)

Asthma

Heart conditions

Ear or sinus problems

Seizures or epilepsy

Diabetes

High blood pressure

Lung disease

Recent surgery

Motion sickness

Other:

Are you pregnant or suspect you may be pregnant?

Do you smoke?

Do you consume alcohol regularly?

Have you ever had issues with equalizing pressure in your ears?

Are you comfortable swimming in deep water?

Fitness Level

How would you rate your overall fitness level?

Excelent

Good

Average

Poor

Do you exercise regularly?

Can you swim at least 200 meters without stopping?

Can you tread water for at least 10 minutes?

Diving Preferences

What type of diving are you interested in? (Check all that apply)

Scuba diving

Snorkeling

Free diving

Technical diving

Recreational diving

Other:

What is your preferred diving environment?

Tropical waters

Cold waters

Freshwater lakes/rivers

Ocean/sea

Other:

Are you interested in obtaining a diving certification?

If yes, which level?

Open Water

Advanced

Rescue Diver

Other:

Do you have any specific diving goals?

Underwater photography

Marine conservation

Exploration

Other:

Equipment

Do you own any diving equipment?

If yes, please list:

Will you require rental equipment?

Additional Information

Do you have any fears or concerns about diving?

If yes, please explain:

Are you traveling with a group or alone?

Group

Alone

Other:

Do you have any dietary restrictions or allergies we should be aware of?

If yes, please specify:

Any other comments or special requests?

Declaration

I confirm that the information provided above is accurate to the best of my knowledge.

I understand that diving involves inherent risks, and I am responsible for disclosing any medical conditions or concerns that may affect my safety.

 

Signature:

Inquiry Form Insights

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The Diving Inquiry Form is a comprehensive tool designed to gather essential information about a potential diving student. Its purpose is to ensure the safety, suitability, and enjoyment of the diving experience for the participant while allowing the diving instructor or organization to assess risks, provide appropriate guidance, and tailor the activity to the individual's needs. Below is an insight into the key sections of the form and their importance:

1. Personal Information

  • Purpose: Collects basic details about the participant and emergency contact information.
  • Insight: This section ensures that the diving organization can communicate effectively with the participant and respond appropriately in case of an emergency.

2. Diving Experience

  • Purpose: Assesses the participant's prior diving experience and certifications.
  • Insight: Understanding the participant's skill level helps instructors determine the appropriate type of diving activity (e.g., beginner vs. advanced) and whether additional training or supervision is required. It also ensures that the participant is placed in a program that matches their experience level.

3. Health and Medical Information

  • Purpose: Identifies any medical conditions or medications that could affect the participant's ability to dive safely.
  • Insight: Diving can be physically demanding and may pose risks to individuals with certain health conditions (e.g., asthma, heart conditions, or ear problems). This section helps identify potential risks and determine if a medical clearance from a doctor is required before diving.

4. Fitness Level

  • Purpose: Evaluates the participant's physical fitness and swimming ability.
  • Insight: Diving requires a reasonable level of fitness and comfort in the water. This section ensures that the participant can handle the physical demands of diving, such as swimming to the surface or managing equipment underwater.

5. Diving Preferences

  • Purpose: Understands the participant's interests and goals for diving.
  • Insight: This section helps the instructor or organization tailor the diving experience to the participant's preferences, whether they are interested in recreational diving, underwater photography, or obtaining a certification. It also helps match the participant with the right type of diving environment (e.g., tropical vs. cold water).

6. Equipment

  • Purpose: Determines whether the participant has their own equipment or requires rentals.
  • Insight: Knowing the participant's equipment needs allows the organization to prepare in advance and ensure that all necessary gear is available and properly fitted.

7. Additional Information

  • Purpose: Gathers any other relevant details, such as fears, dietary restrictions, or special requests.
  • Insight: This section provides a space for the participant to share any concerns or requirements that may not be covered in other sections. For example, a participant with a fear of deep water may need additional reassurance or a gradual introduction to diving.

8. Declaration

  • Purpose: Confirms the accuracy of the information provided and acknowledges the risks associated with diving.
  • Insight: This legal and ethical component ensures that the participant understands the inherent risks of diving and takes responsibility for disclosing any relevant medical or personal information.

Key Benefits of the Form

  1. Safety: Identifies potential health risks and ensures that participants are physically and mentally prepared for diving.
  2. Personalization: Tailors the diving experience to the participant's skill level, interests, and goals.
  3. Risk Management: Helps the diving organization mitigate risks by gathering all necessary information upfront.
  4. Efficiency: Streamlines the onboarding process by collecting all relevant details in one place.
  5. Legal Protection: Provides a record of the participant's disclosures and acknowledgment of risks, which can be important in case of an incident.

Mandatory Questions Recommendation

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The mandatory questions on a diving client intake form are those that are critical for safety, legal liability, and risk assessment. These questions help ensure the participant is medically and physically fit for diving, has the necessary experience, and understands the risks involved. Below are the essential mandatory questions that should never be omitted:

1. Personal Information (Mandatory for All)

  • Full Name
  • Date of Birth (to verify age restrictions)
  • Emergency Contact Name & Number
  • Signature & Date (legal acknowledgment)

Why?

  • Ensures proper identification and emergency response.
  • Legal requirement for liability and consent.

2. Medical Screening (Critical for Safety)

  • "Do you have any medical conditions that may affect your ability to dive safely?" (If "Yes," require details.)
  • "Are you currently taking any medications?" (If "Yes," require a list.)
  • "Have you ever experienced any of the following?" (Asthma, heart conditions, lung disease, epilepsy, recent surgery, etc.)
  • "Are you pregnant or suspect you may be pregnant?"

Why?

  • Diving can be dangerous for people with certain medical conditions (e.g., heart disease, asthma, or ear issues).
  • Some medications (e.g., decongestants, blood pressure meds) can interact with diving.
  • Pregnancy is an absolute contraindication for diving.

3. Diving Experience (Assesses Risk Level)

  • "Have you ever gone diving before?" (If "Yes," specify type and certification level.)
  • "Are you currently certified by a diving organization (e.g., PADI, SSI)?"

Why?

  • Determines if the participant needs beginner training or can join advanced dives.
  • Ensures uncertified divers are not placed in unsafe situations.

4. Fitness & Swimming Ability (Safety Requirement)

  • "Can you swim at least 200 meters without stopping?"
  • "Can you tread water for at least 10 minutes?"

Why?

  • Diving requires basic swimming competency for safety in emergencies.
  • Industry standards (e.g., PADI/SSI) require these skills for certification.

5. Liability Waiver & Legal Consent (Mandatory)

  • "I confirm that the information provided is accurate and understand the risks of diving."
  • Signature & Date

Why?

  • Protects the dive operator from liability claims.
  • Ensures the participant acknowledges inherent risks.

Optional but Recommended Questions

  • Equipment preferences (own vs. rental)
  • Diving goals (recreational, photography, certification)
  • Dietary restrictions (if providing post-dive meals)

Key Takeaways

  1. Medical questions are non-negotiable – A "Yes" to certain conditions may require a doctor’s clearance.
  2. Swimming ability must be verified – Weak swimmers may need extra supervision.
  3. Certification level dictates dive eligibility – Uncertified divers cannot do advanced dives.
  4. Legal waiver is mandatory – Without it, the dive operator assumes unnecessary risk.

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